Laserfiche WebLink
0 0 FORM NO.AES003 <br /> SERVICE ORDER <br /> - = No. N 624216 <br /> ASBURY ENVIRONMENTAL SERVICES <br /> 1300 S.SANTA FE AVENUE ❑ COMPTON,CALIFORNIA 90221 ❑ (310) 886-3400 <br /> SAN DIEGO OFFICE NORTHERN CALIFORNIA <br /> 1-800-748-5744 EPA CAD0.28277036 1-800-727-2879 <br /> DATE <br /> ONE TIME PICK UP ❑YES or ❑NO <br /> CUSTOMER RESIDENCE ❑ YES or ❑ NO <br /> BILLING ADDRESS CONTRACT CUSTOMER ❑ YES or ❑ NO <br /> PLEASE PAY FROM THIS <br /> SERVICE ORDER <br /> PHONE CONTACT CUSTOMER NUMBER <br /> CUSTOMER EPA# AMOUNT <br /> JOB SITE ADDRESS CHECK NUMBER <br /> r-- <br /> P.O.NUMBER <br /> CROSS STREETS CASH RECEIVED <br /> (AMOUNT) <br /> NOTES; COMMODITY <br /> HALIDES P.P.M. <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(USED OIL/MIXED OILS)STATE CODE 221 <br /> *NO PLACARDS REQUIRED* <br /> ❑ NON-RCRA HAZARDOUS WASTE, LIQUID(ETHYLENE GLYCOL SOLUTIONS)STATE CODE 133 <br /> *NO PLACARDS OR MARKINGS REQUIRED* NEXT SERVICE DATE <br /> 0 OTHER DRUMS DRUM SIZE <br /> MANIFEST NO. <br /> NO.OF GALLONS <br /> DRIVER TRUCK NO.&RT <br /> NON HAZARDOUS DRAINED USED OIL FILTER <br /> ❑ COMMERCIAL FILTER RECYCLING,33210 Western Avenue, Union City,CA,510-487-9277 <br /> LJ ALTERNATE FACILITY <br /> DESIGNATED TSDF: ❑ ALVISO INDEPENDENT OIL 5002 Archer Street-Alviso,CA 95502.CAL000161743.(510)476-1740 <br /> ❑ BAYSIDE OIL 11,INC.•210 Encinal Street•Santa Cruz,CA 95060•CAD088838222•(408)427-3778 <br /> ❑ EVERGREEN ENV.+4139 N.Valentine Ave. .Fresno, CA 93722.CA0982446882.(510)795-4400 <br /> ❑ 'DEMENNO/KERDOON •2000 N.Alameda Street•Compton,CA 90222•CAT080013352-(310)537-7100 <br /> ❑ DIK DIXON.7300 Chevron Way.Dixon,CA 95620.CAT080012602.(707)693-6008 <br /> ❑ RAMOS ENVIRONMENTAL.1515 S.River Road .W.Sacramento,CA 95691 .CA0044003556 .(916)371-5747 <br /> ❑ ASBURY ENVIRONMENTAL SERVICES•2549 Scott Avenue•Chico, CA 95928•CAL000827844 <br /> E7 ALTERNATE FACILITY <br /> USED OIL,USED ANTIFREEZE AND OILY WATER WASTE STREAMS ARE <br /> RECYCLED AT OUR SISTER COMPANY DEMENNOIKERDOON THE This is to certify that the above named articles are properly classified, described, packaged, marked <br /> LARGEST RECYCLER OF USED OIL IN THE WESTERN UNITED STATES. and labeled,and are in proper condition for transportation,according to the applicable regulations of <br /> the Department of Transportation. <br />*1 HEREBY CERTIFY THAT I HAVE NOT MIXED THIS WASTE WITH ANY <br /> OTHER WASTE,THAT THE TOTAL HALIDES ARE LESS THAN 1000 P.P.M.; X I J <br /> AND THAT THE WASTE DOES NOT CONTAIN ANY P.C.B'S., CUSTOMER SIGNATURE DATE <br />*I FURTHER AGREE TO ACCEPT THE ADDITIONAL CHARGES FOR LEGAL X <br /> DISPOSAL IF THIS WASTE IS.OVER 1000 P.P.M.TOTAL HALIDES, OR <br /> CONTAINS ANY P:C.B'S. PRINT NAME <br />